There are innumerable minor, but nonetheless quite distressing, symptoms associated with Parkinson’s disease, with skin problems being one of them. Some of these skin problems may be due to the disease itself although drug therapy for Parkinson’s disease is often responsible. While the side effects of these medicines do cause significant distress at times, it is important to note that the drugs are essential in managing Parkinson’s disease and should not be stopped or changed without your doctor’s approval.

Types of Skin Problems in Parkinson’s Disease

• Oily skin. There is excessive oiliness of the skin on the face, especially on the forehead and on the sides of the nose, making the skin look greasy and shiny.
• Dandruff. The scalp may become oily, resulting in greasy hair and dandruff.
• Seborrheic dermatitis. Inflammation of the skin may occur, causing the skin to become red and itchy, with a tendency to flake.
• Dry skin. In some cases there is extreme dryness of the skin due to too little perspiration.
• Excessive sweating. Too much perspiration can be a distressing symptom.
• Night sweats are quite common in patients with Parkinson’s disease.

Causes of Skin Problems in Parkinson’s Disease

Skin problems may occur as a result of Parkinson’s disease and improper functioning of the autonomic nervous system, or sometimes as a side effect of anti-Parkinson drugs.

• The sebaceous glands in the skin produce sebaceous matter or sebum, which help to protect the skin and keep it supple. Excessive production of sebum may occur in Parkinson’s disease and the areas that contain more sebaceous glands, such as on the forehead, beside the nose, and scalp are more severely affected. This causes oily skin and dandruff and in extreme cases the skin may become red, inflamed and itchy. Heat may exacerbate this problem.
• In Parkinson’s disease, sweat glands may produce too little or too much sweat, causing problems of dry skin or excessive perspiration. Anti-Parkinson drugs also have side effects causing too much sweating (with medicines such as levodopa), or too little sweating (due to anticholinergics).

Treatment of Skin Problems in Parkinson’s Disease

• For oily and greasy skin, standard treatments, such as using a neutral soap (unscented glycerin soap) and washing the skin twice daily with warm water and rinsing with cold water, do help. It is preferable to use gels since they are water based, than creams which are oil based. In more severe cases, a cream containing sulfur and salicylic acid may give better results.
• Various lotions and shampoos are available for treatment of dandruff. Selenium or selenium sulfide containing products may give good results.
• Seborrheic dermatitis may need treatment with lotions containing a steroid such as adrenocorticotrophic hormone, or a ketoconazole containing cream. Coal tar shampoo may be effective for forehead and eyebrows.
• Taking lukewarm showers, wearing light cotton clothes in summer, and drinking plenty of water and liquids are helpful in combating the effects of excessive perspiration. Excessive sweating may sometimes be due to side effects of anti-Parkinson drugs such as levodopa or can occur during the “wearing off” period of levodopa treatment -adjusting the dose, using a controlled release levodopa preparation, or COMT inhibitors may help. Beta-blockers, anticholinergics, or use of astringents containing glutaraldehyde also help in some cases.
• Too little perspiration may be helped by reducing the dose of anti-Parkinson medicines such as anticholinergics.